| 1 | A bill to be entitled |
| 2 | An act relating to third-party liability; amending s. |
| 3 | 213.053, F.S.; expanding the authority of the Department |
| 4 | of Revenue to provide the Agency for Health Care |
| 5 | Administration with tax information; reenacting s. |
| 6 | 206.27(2), F.S., relating to records and files as public |
| 7 | records, to incorporate the amendment to s. 213.053, F.S., |
| 8 | in a reference thereto; amending s. 409.910, F.S.; |
| 9 | requiring third-party liability administrators and |
| 10 | pharmacy benefits managers to provide certain records and |
| 11 | information relating to payments on behalf of Medicaid- |
| 12 | eligible persons; amending s. 733.2121, F.S.; requiring |
| 13 | the personal representative of a decedent to provide a |
| 14 | copy of a death certificate to the Agency for Health Care |
| 15 | Administration; providing an effective date. |
| 16 |
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| 17 | Be It Enacted by the Legislature of the State of Florida: |
| 18 |
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| 19 | Section 1. Paragraph (m) of subsection (7) of section |
| 20 | 213.053, Florida Statutes, is amended to read: |
| 21 | 213.053 Confidentiality and information sharing.-- |
| 22 | (7) Notwithstanding any other provision of this section, |
| 23 | the department may provide: |
| 24 | (m) Information relative to chapter 198 to the Agency for |
| 25 | Health Care Administration in the conduct of its official |
| 26 | business relating to ss. 409.901-409.9101 409.901-409.910. |
| 27 |
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| 28 | Disclosure of information under this subsection shall be |
| 29 | pursuant to a written agreement between the executive director |
| 30 | and the agency. Such agencies, governmental or nongovernmental, |
| 31 | shall be bound by the same requirements of confidentiality as |
| 32 | the Department of Revenue. Breach of confidentiality is a |
| 33 | misdemeanor of the first degree, punishable as provided by s. |
| 34 | 775.082 or s. 775.083. |
| 35 | Section 2. For the purpose of incorporating the amendment |
| 36 | to section 213.053, Florida Statutes, in a reference thereto, |
| 37 | subsection (2) of section 206.27, Florida Statutes, is reenacted |
| 38 | to read: |
| 39 | 206.27 Records and files as public records.-- |
| 40 | (2) Nothing herein shall be construed as requiring the |
| 41 | department to provide as a public record any information |
| 42 | concerning audits in progress or those records and files of the |
| 43 | department described in this section which are currently the |
| 44 | subject of pending investigation by the Department of Revenue or |
| 45 | the Florida Department of Law Enforcement. It is specifically |
| 46 | provided that the foregoing information shall be exempt from the |
| 47 | provisions of s. 119.07(1) and shall be considered confidential |
| 48 | pursuant to s. 213.053; however, the department may make |
| 49 | available to the executive director of the Department of Highway |
| 50 | Safety and Motor Vehicles or his or her designee, exclusively |
| 51 | for official purposes in administering chapter 207, any |
| 52 | information concerning any audit in progress, and the provisions |
| 53 | of s. 213.053(7) requiring a written agreement and maintenance |
| 54 | of confidentiality by the recipient, and the penalty for breach |
| 55 | of confidentiality, shall apply if the department makes such |
| 56 | information available. Any officer, employee, or former officer |
| 57 | or employee of the department who divulges any such information |
| 58 | in any manner except for such official purposes or under s. |
| 59 | 213.053 is guilty of a misdemeanor of the first degree, |
| 60 | punishable as provided in s. 775.082 or s. 775.083. |
| 61 | Section 3. Subsection (20) of section 409.910, Florida |
| 62 | Statutes, is amended to read: |
| 63 | 409.910 Responsibility for payments on behalf of Medicaid- |
| 64 | eligible persons when other parties are liable.-- |
| 65 | (20) Entities providing health insurance as defined in s. |
| 66 | 624.603, and health maintenance organizations and prepaid health |
| 67 | clinics as defined in chapter 641, and, on behalf of their |
| 68 | clients, third-party administrators and pharmacy benefits |
| 69 | managers as defined in s. 409.901(26) shall provide such records |
| 70 | and information as are necessary to accomplish the purpose of |
| 71 | this section, unless such requirement results in an unreasonable |
| 72 | burden. |
| 73 | (a) The director of the agency and the Director of the |
| 74 | Office of Insurance Regulation of the Financial Services |
| 75 | Commission shall enter into a cooperative agreement for |
| 76 | requesting and obtaining information necessary to effect the |
| 77 | purpose and objective of this section. |
| 78 | 1. The agency shall request only that information |
| 79 | necessary to determine whether health insurance as defined |
| 80 | pursuant to s. 624.603, or those health services provided |
| 81 | pursuant to chapter 641, could be, should be, or have been |
| 82 | claimed and paid with respect to items of medical care and |
| 83 | services furnished to any person eligible for services under |
| 84 | this section. |
| 85 | 2. All information obtained pursuant to subparagraph 1. is |
| 86 | confidential and exempt from s. 119.07(1). |
| 87 | 3. The cooperative agreement or rules adopted under this |
| 88 | subsection may include financial arrangements to reimburse the |
| 89 | reporting entities for reasonable costs or a portion thereof |
| 90 | incurred in furnishing the requested information. Neither the |
| 91 | cooperative agreement nor the rules shall require the automation |
| 92 | of manual processes to provide the requested information. |
| 93 | (b) The agency and the Financial Services Commission |
| 94 | jointly shall adopt rules for the development and administration |
| 95 | of the cooperative agreement. The rules shall include the |
| 96 | following: |
| 97 | 1. A method for identifying those entities subject to |
| 98 | furnishing information under the cooperative agreement. |
| 99 | 2. A method for furnishing requested information. |
| 100 | 3. Procedures for requesting exemption from the |
| 101 | cooperative agreement based on an unreasonable burden to the |
| 102 | reporting entity. |
| 103 | Section 4. Paragraph (d) of subsection (3) of section |
| 104 | 733.2121, Florida Statutes, is amended to read: |
| 105 | 733.2121 Notice to creditors; filing of claims.-- |
| 106 | (3) |
| 107 | (d) If a decedent at the time of death was 55 years of age |
| 108 | or older, the personal representative shall promptly serve a |
| 109 | copy of the notice to creditors and provide a copy of the death |
| 110 | certificate on the Agency for Health Care Administration within |
| 111 | 3 months after the first publication of the notice to creditors, |
| 112 | unless the agency has already filed a statement of claim in the |
| 113 | estate proceedings. |
| 114 | Section 5. This act shall take effect July 1, 2005. |